Jeremy Michael Hurford, PA-C
Individual provider Active NPI Physician Assistant · Okeene, OK
NPI 1669845772 · NPPES record last updated Oct 28, 2020
Key facts
- NPI
- 1669845772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2599 (OK)
- Practice address
- 124 N 6TH St
Okeene, OK 73763-9135 - Phone
- (580) 833-4404
- Fax
- (580) 822-4403
- NPI assigned
- Nov 11, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dynamic Wound Care LLC
Practice addresses (Care Compare)
2222 Shadowlake Dr
Oklahoma City, OK 73159-7440
Phone (405) 554-3344
Hospital & facility affiliations
- Okeene Municipal Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160203000773 | OK | Practitioner - Physician Assistant | 5193029668 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Okeene Municipal Hospital and Schallmo Authority | Current |
Accepting new patients | |
| Okeene Municipal Hospital and Schallmo Authority | Current |
Accepting new patients | |
| Verdure Health Services | Past | Accepting new patients |
Locations
124 N 6th St
Okeene, OK 73763
Phone (580) 822-4404
207 E F St
Okeene, OK 73763
Phone (580) 822-4321
Interoperability endpoints
- jhurford157195@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2599 | OK | Yes |
Addresses
Primary practice location
124 N 6TH St
Okeene, OK 73763-9135
Mailing address
PO Box 389
Okeene, OK 73763-0389
Phone (580) 822-4404
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 471025ZL9Z | Other | OK | MEDICARE PTAN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jhurford157195@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Other providers in Okeene, OK
- Kirt Eugene Bierig
- Cayci L Brickman
- Kadree Ann Giblet
- Mason Ray Howe
- James Sims MSN RN Arnp LLC
- Henry D Lagan
- Luckie Drug LLC
- Jim W Luckie
- Okeene Dentistry & Braces
All providers in Okeene, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.